Household Survey Comparison

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Household Survey Comparison
Melissa Heinen, M.P.H. Margaret Warner,
Ph.D. Lois Fingerhut, M.A. Montreal 2002
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Importance of Household Surveys

• Not limited to medical records
• Health professionals description
• More detail about the event
• Costs and resources

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National Household Injury Surveys

• Surveys reviewed
• Canada Canadian Community Health Survey (CCHS)
  and the National Population Health Survey (NPHS)
• New Zealand National Health Survey
• Scotland Scottish Health Survey
• South Africa South African Demographic and
  Health Survey
• United States National Health Interview Survey

SOURCE CDC/NCHS
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National Household Injury Surveys

• Items compared
• Recall Period
• Severity Threshold
• Survey Methodology
• Unit of Analysis
• Injury Definitions
• Survey Frequency
• Probing / Screening Question

SOURCE CDC/NCHS
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Recall Period

• Items to consider
• Memory decay
• Telescoping
• Heaping
• Sample size / relative standard error

SOURCE CDC/NCHS
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Annual estimates of injury and poisoning
conditions using different recall periods, NHIS
1997
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Recall Period
SOURCE CDC/NCHS
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Severity Threshold

• Measurements
• Limitation in daily activities
• Medical advice or treatment
• Hospitalization status

SOURCE CDC/NCHS
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Severity Threshold

• Items to consider
• Health insurance coverage
• Subjective - health seeking behaviors
• Accessibility of health professional (rural vs.
  urban)
• Emergency department visits

SOURCE CDC/NCHS
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Severity Threshold
SOURCE CDC/NCHS
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Survey Methodology

• Items to consider
• Non-response rates
• Representation
• Sensitive questions and non-reporting
• Cost and resources

SOURCE CDC/NCHS
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Survey Methodology
SOURCE CDC/NCHS
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Unit of Analysis

• Items to consider
• Comparability of numbers
• Events (e.g., car crash)
• Persons
• Most severe
• Most recent
• Conditions (e.g., fractured leg)

SOURCE CDC/NCHS
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Unit of Analysis
SOURCE CDC/NCHS
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Injury Definitions

• Items to consider
• Self report vs. coding of self reports (ICD
  coding)
• Comparability

SOURCE CDC/NCHS
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Injury Definitions
SOURCE CDC/NCHS
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Survey Frequency

• Items to consider
• Trends over time
• Assess data
• Sample size

SOURCE CDC/NCHS
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Survey Frequency
SOURCE CDC/NCHS
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Screener Question

• Items to consider
• Length
• Complexity
• Embedded examples

SOURCE CDC/NCHS
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Screener Question
SOURCE CDC/NCHS
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Screener Question
SOURCE CDC/NCHS
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US Survey

• Decrease injury rate
• Cognitive testing -screening question
• Length
• Definitions
• Severity

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Screener Question

• Proposed changes for US
• During the past 3 months, that is since , did
  you have an injury where any part of your body
  was hurt, for example, with a broken bone,
  sprain, burn, wound, cut, bruise, or animal or
  insect bite?
• During the past 3 months, how many times were you
  injured?
• Did you talk to or see a medical professional
  about any of these injuries?
• Of the times that you were injured, how many of
  those times was the injury serious enough that
  you consulted a medical professional?

SOURCE CDC/NCHS
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Screener Question

• Proposed changes for US
• During the past 3 months, that is since , were
  you poisoned by swallowing or breathing in a
  harmful substance such as bleach, carbon
  monoxide, or too many pills or drugs? (Do not
  include food poisoning, sun poisoning, or poison
  ivy rashes)
• During the past 3 months, how many different
  times were poisoned?
• Did you talk to or see a medical professional
  about any of these poisonings?
• Of the times that you were poisoned, how many
  of those times was the poisoning serious enough
  that you consulted a medical professional?

SOURCE CDC/NCHS
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National Household Injury Surveys

• Additional items to consider
• Placement of injury section within a larger
  survey
• Length of survey
• Sample selection
• Definitions of injuries and poisonings
• Narrative introduction to the section
• Weighting of data
• Respondent vs. Proxy

SOURCE CDC/NCHS
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National Household Injury Surveys

• Generic considerations
• Continuous funding
• Strong lobbying
• Demonstrating usefulness of data

SOURCE CDC/NCHS
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Website http//www.cdc.gov/nchs/about/otheract/ic
e/housesur.htm
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Considerations

• Should our goal be to compare our selves to each
  other to have better questions and survey
  methodology?
• Is it a worthwhile goal to standardize questions?
• Cause compatible with ICD?
• Should health behaviors be a priority?
• Is it even worth comparing numbers?